Provider Demographics
NPI:1790018091
Name:BAYTOWN DENTAL GROUP
Entity Type:Organization
Organization Name:BAYTOWN DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YAMMINE
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:YAMMINE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-387-8400
Mailing Address - Street 1:1107 E JAMES ST
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-5821
Mailing Address - Country:US
Mailing Address - Phone:281-837-8400
Mailing Address - Fax:281-837-9999
Practice Address - Street 1:1107 E JAMES ST
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-5821
Practice Address - Country:US
Practice Address - Phone:281-837-8400
Practice Address - Fax:281-837-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty